Prognostic significance of angiogenesis in human pancreatic cancer

To evaluate whether angiogenic factors are of clinical relevance to actual human pancreatic cancers, we studied the intratumoral microvessel density ( IMD), and PD-ECGF, VEGF protein expression in 40 pancreatic cancers using i mmunohistochemistry. We also investigated PD-ECGF and VEGF gene expression using reverse transcriptase-PCR (RT-PCR). Of the 40 pancreatic cancers stud ied, 30 carcinomas (75.0%) were evaluated to be PD-ECGF-positive and 10 car cinomas (25.0%) were determined to be PD-ECGF-negative. In contrast, 27 car cinomas (67.5%) were evaluated to be VEGF-positive, whereas 13 carcinomas ( 32.5%) were VEGF-negative. VEGF gene expression was moderately associated w ith an increase in the IMD (r(2) = 0.181, P = 0.006), but no significant re lationship was found between PD-ECGF gene expression and the IMD (r(2) = 0. 093, P = 0.059), However, tumours with positive expression for both PD-ECGF and VEGF had a higher IMD (P = 0.027), The results of the immunohistochemi stry agreed well with the results of the quantitative RT-PCR, The median su rvival time of the hypervascular group was significantly shorter than that of the hypovascular group (P < 0.0001). In comparing the survival according to PD-ECGF and VEGF gene expression, the median survival time of the patie nts with positive PD-ECGF expression was significantly shorter than those w ith negative PD-ECGF expression (P = 0.040). Furthermore, the median surviv al time of the patients with positive VEGF expression was significantly sho rter than those with negative VEGF expression (P = 0.048), However, the Cox multivariate analysis indicated that the IMD and VEGF expression were inde pendent prognostic factors of the various clinicopathologic variables in pa ncreatic cancer patients (P = 0.0021 and P = 0.0443, respectively).